Psoriazisin klinik şiddeti ile histopatolojik bulgular arasında ilişki var mıdır? klinikopatolojik bir çalışma

Year 2019, , 319 - 324, 30.06.2019

Figen Aslan

https://doi.org/10.17826/cumj.461671

Abstract

Amaç: Psoriazis, şiddeti hastadan hastaya değişen yaygın bir kronik inflamatuar deri hastalığıdır. Bu çalışmada, histopatolojik bulgular ile hastalığın klinik şiddeti arasında ilişki olup olmadığını araştırmayı amaçladık.

Gereç ve Yöntem: Bu retrospektif çalışmada, hem klinik hem de deri biyopsisi ile histopatolojik olarak psoriazis vulgaris tanısı konulan 51 olgu incelendi. Olguların parafin bloklarından hazırlanan kesitleri mikroskobik olarak incelendi ve bulgular çeşitli histopatolojik özellikler açısından kaydedildi. Hastalığın şiddetini  değerlendirmek için psoriazis alan şiddet indeksi (PASI) kullanıldı. PASI ile ilgili veriler hastaların tıbbi dosyalarından elde edildi. Hastalar daha sonra yüksek PASI skoru (≥10) ve düşük PASI skoru (<10) olanlar olarak gruplandırıldı. Histopatolojik özellikler ile PASI skoru arasındaki ilişki Pearson korelasyon testi ile değerlendirildi.

Bulgular: Elli bir hastanın yaş ortalaması 45.19 idi. Çalışmada, Psoriazis vulgaris olgularında (31 erkek, 20 kadın) 1.5: 1 olan erkek: kadın oranıyla erkek baskınlığı görüldü. Psoriazisin aile öyküsü % 29 hastada pozitifti. En sık görülen histopatolojik özellikler: hiperkeratoz (% 100), parakeratoz (% 100) (fokal parakeratoz (% 23), konfluent parakeratoz (% 77)), rete ridgelerin uzaması (% 98) ve vasküler dilatasyon (% 88) idi.  Hastaların 30'unda (% 58.8) düşük PASI skoru (<10), 21'inde (% 41.2) yüksek PASI skoru (≥10) vardı. Hastalığın şiddeti (PASI skoru) ile histopatolojik özelliklerin herhangi biri ile ilişki bulunmadı. 

Sonuç: Psoriazisin karakteristik temel histopatolojik bulguları olmasına rağmen bu histopatolojik bulguların hiçbiri doğrudan hastalığın klinik şiddeti  ile ilişkili değildir.

Keywords

Psoriazis, Histopatoloji, Klinik şiddet, PASI

Is there a relationship between clinical severity of psoriasis and histopathological findings? a clinicopathological study

Abstract

Purpose:  In this study, we aimed to investigate whether there is a relationship between histopathologic findings and clinical severity of the disease.

Materials and Methods: In this retrospective study, 51 cases with psoriasis vulgaris diagnosed both clinically and histopathologically through a skin biopsy were analyzed. The sections prepared from the paraffin blocks of the cases were examined microscopically and the findings were recorded for various histopathological features. The psoriasis area severity index (PASI) used to assess the severity of the disease. Data regarding PASI were obtained from the patients’medical files. The patients were then grouped as those with high PASI score (≥10) and

low PASI score (<10). The relation between the histopathological features and the PASI score was assessed with the Pearson’s correlation test.

Results: The meanage of 51 patients was 45.19 years old. The study showed male predominance with male:female ratio-1.5:1 of psoriasis vulgaris cases (31 males, 20 females). Family history of psoriasis was positive in 29% patients. The most prevalent histopathological features were hyperkeratosis (100%), parakeratosis (100%) (focal parakeratosis (23%), confluent parakeratosis (77%)),  elongation of rete ridges (98%), and vascular dilatation (88%). Out of the patients, 30 (58.8%) had low PASI score (<10),whereas 21 (41.2%) had high PASI score (≥10). There was no relationship between the severity of the disease (PASI score) and any of the histopathological features. 

Conclusion: Although there are characteristic histopathological findings of psoriasis, none of these histopathological findings are directly related to the clinical severity of the disease.

Keywords

Psoriasis, Histopathology, Clinical severity, PASI

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